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Suggestions for In-Person Feeding Therapy with COVID Precautions

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As the opportunity to safely resume in-person therapy becomes an option, there are many things to keep in mind in addition to safety. We have created a list of suggestions to consider in order to best serve your clients and to also keep everyone safe during Feeding Therapy. As always, please check the State/Governmental recommendations and requirements (ASHA Telehealth Guidelines & AOTA Telehealth Regulations by State) in your geographic area, as well as your Institution’s new Health and Safety policies. 

*If you have not yet taken the SOS Approach to Feeding (4 Day) Training Conference, some of the strategies discussed below may not be clear to you.  Please consider taking one of our Training Conferences, especially now as they are being offered as Virtual Conferences live-streamed and on-line.  You can check our Training Schedule to find a conference that may work for you.

Therapist Health Screen

Therapists treating in a Clinic or Hospital Setting should have their temperature taken upon arrival at their clinical setting every day, and they should sign a document verifying they do not have a known COVID-19 exposure.  If a Therapist goes into the Client’s Home, the Therapist should take their temperature in the morning before starting their day.  This temperature should be sent to the employer who keeps a record of the temperature, along with the Therapist’s daily statement of no known COVID-19 exposure.

Food Preparation & Supplies

All food preparation should be completed by the child’s Feeding Therapist who is gloved and masked throughout the prep.  Prepared foods should be placed in sealable containers or baggies.  All food prep areas and utensils/dishes are sanitized in between uses.

The Therapist should create one set of foods for themselves, and one set of foods for the Parent/Child. At the end of the session, any extra food should be thrown away or the family could be given their extra portions of the foods to take home with them.

Alternatively, the Therapist could create a Food Hierarchy with the family before the session (via Zoom, email, etc.), and have the family bring their own set of foods to the Clinic for therapy. The Therapist will also create a similar Food Hierarchy for him/herself to use in the clinical setting.  All foods are brought to the session in sealed containers/baggies. The family can take home any extra food that they brought in or throw it away at the end of the session.

If the Therapist is treating the child in the family’s home, a Food Hierarchy should be created with the family before the session.  It is recommended that the Therapist prepare and bring his/her own food in sealable containers/baggies and that the family prepares their own foods separately in their home.  Both the Therapist and Family should prepare foods and other session materials using gloves and masks if possible before the session starts.

Family Precautions

The morning that the session is scheduled, the Family should take the temperature of everyone in the home (including other siblings, caregivers, etc. who are not going to be attending therapy), and confirm with the clinic that everyone is presumed to be healthy with no known COVID-19 exposures. If any family member has a temperature, the session should be canceled.

Only one Parent/Caregiver and the Child (no siblings) are allowed into the Clinic for the appointment, and they should be wearing masks initially if possible.

Note: Per CDC Recommendations cloth face coverings should not be placed on young children under age 2, anyone who has trouble breathing, or is unconscious, incapacitated, or otherwise unable to remove the mask without assistance.

The family should wait in the car for the Therapist, who will escort them into the Clinic (they can call/text the therapist or front office staff when they arrive).  The Therapist should be wearing a mask or a clear plastic face shield, which is preferred if available, and clear plastic gloves.  The Child and Parent’s temperature are taken by the Therapist and recorded either before the family gets out of the car or immediately upon their entry into the Clinic. Additionally, the Parent will sign documentation indicating that the Family has no known COVID-19 exposure AND that members of the household do not work in a setting with a high risk of COVID-19 exposure.

Sensory Preparation

It is not recommended to utilize a large sensory gym space where there are many surfaces that would need to be cleaned between each client. Masks and gloves may be required if the Therapist and Child/Parent will be closer than 6 feet from each other. Sensory Preparation ideas will likely need to be individualized to each child, but might include:

Work with Food

Ideally, the Child will be seen in a large Feeding space at a table that allows the Therapist to be 6 feet away from the Parent and Child (maybe utilizing a long folding table or placing 2 therapy tables together to make one larger table).  The Parent and Child would sit at one end of the table with their food and supplies, and the Therapist sits at the other end of the table with his/her foods and supplies.  Everyone can remove their masks and gloves at this time since there will be no sharing of materials and there is distance between the Family and Therapist. The Parent presents the bubbles, paper towels/hand wipes, plates, napkins, and foods to the child – one at a time – with the Therapist coaching the Parent as they do this. The Therapist should simultaneously model and complete the actions for themselves from their own set of supplies.

Here is an example of how you might set up your therapy space. You can see in this small room, two tables were pushed together with a plexiglass shield between the table. The therapist sits on one side with one set of supplies and foods, and the parent and child sit on the other side with their own separate set of supplies and foods.

Setting Up for Success

Depending on the skill and experience of the Parent, they can help to lead the session with the Therapist coaching.  If the Family is newer to feeding therapy and/or the Parent not as experienced in playing with food, the Therapist will be leading the session from their side of the table with the expectation that the Parent will imitate and model everything the Therapist does.

If your clinic has come up with other ideas that have been successful that you wish to share, please contact us and let us know what has been working for you! You can e-mail other suggestions to Lindsay at [email protected]

We hope you continue to stay happy and healthy, safe, and sane during these challenging times!

More Information & COVID Resources

SOS Information & Support for Coronavirus

Suggestions for Transitioning to Telehealth using the SOS Approach

Increased Feeding Challenges due to Stressful Times and Life Changes

SOS Conference Schedule Updates


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